Researchers from the University of Alabama at Birmingham used U.S. Medicaid data from 2000 to 2005 to compare the incidence of bacterial infection in children with and without juvenile idiopathic arthritis (JIA). It was determined that children with juvenile idiopathic arthritis have higher rates of hospitalization for bacterial infection than children without juvenile idiopathic arthritis. The risk of bacterial infection significantly increased with the use of high-dose glucocorticoids (10 mg. prednisone or more daily), but the use of methotrexate or TNF blockers was not found to increase the risk of bacterial infection among children with JIA.
Interestingly, the findings also suggested that the inflammatory or autoimmune process of JIA itself may increase the risk of infection, no matter which treatment was used. But steroids were found to double the risk of bacterial infection among JIA patients compared to those not taking steroids. When possible, avoiding steroids in JIA patients may be the preferred treatment course.
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